Iso-osmolar Prehydration Shifts the Cytokine Response Towards a More Anti-Inflammatory Balance in Human Endotoxemia

J Endotoxin Res. 2005;11(5):287-93. doi: 10.1179/096805105X58715.

Abstract

Clinical experience suggests that the administration of fluids in human endotoxemia reduces symptoms. In the present study, the effects of a standardised fluid protocol on symptoms, inflammatory and hemodynamic parameters in human endotoxemia are determined. With approval of the local ethics committee, 16 healthy volunteers received 2 ng/kg of Escherichia coli endotoxin (O:113). After an overnight fast, nine subjects received 1.5 l of 2.5% glucose/0.45% NaCl the hour prior to the endotoxin administration and 150 ml/h during the course of the experiment ('prehydrated group'). Seven subjects only received a continuous infusion of 75 ml/h during the experiment ('non-prehydrated group'). The course of inflammatory parameters and symptoms were determined and mean arterial pressure, heart rate and forearm blood flow were measured. In the prehydrated group, TNF-alpha increased to 522 +/- 63 pg/ml (mean +/- SEM) while the maximum in the non-prehydrated group was 927 +/- 187 pg/ml (P < 0.04). IL-10 increased similarly in both groups (non-prehydrated 117 +/- 18 pg/ml and prehydrated 99 +/- 18 pg/ml; P = NS). The prehydrated group had a significantly lower (P < 0.004) symptom score and recovered sooner (P = 0.004). Endotoxin-induced changes in hemodynamics revealed no significant differences between groups. We demonstrate that prehydration in experimental human endotoxemia significantly shifts the cytokine balance towards a more anti-inflammatory pattern. This effect is associated with a reduction in symptoms, whereas the changes in hemodynamic parameters are not influenced by prehydration.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cytokines / analysis
  • Cytokines / biosynthesis
  • Cytokines / immunology*
  • Endotoxemia / immunology*
  • Endotoxemia / physiopathology
  • Endotoxemia / prevention & control
  • Escherichia coli / pathogenicity
  • Female
  • Fluid Therapy*
  • Humans
  • Inflammation
  • Lipopolysaccharides / toxicity
  • Male
  • Severity of Illness Index
  • Water-Electrolyte Balance

Substances

  • Cytokines
  • Lipopolysaccharides